Mylan-Amilazide

This is a combination product containing 2 medications (amiloride and hydrochlorothiazide) that belong to the class of medications called diuretics. This combination medication is used to decrease edema (fluid retention) that occurs with congestive heart failure and certain liver disorders. It is also used to lower high blood pressure.

This medication works by causing the body to lose excess water and salt. One of the diuretics, amiloride, called a potassium-sparing diuretic, does not cause potassium to be lost from the body, while the other, hydrochlorothiazide, does cause potassium to be lost from the body. When used together, the loss of potassium from the body is minimized.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Mylan-Amilazide is no longer being manufactured for sale in Canada. For brands that may still be available, search under amiloride - hydrochlorothiazide. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

The dose for each individual component (i.e., amiloride and hydrochlorothiazide) should be established before the combination medication is started. The usual dose of amiloride - hydrochorothiazide is one or two tablets daily in one dose or in divided doses. If one dose is taken, it should be taken early in the day to avoid the need to visit the washroom during sleeping hours. This medication may be taken with or without food. Do not take more than four tablets daily.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Some medications can affect vitamin and nutrient levels in the body. Below is a list of nutrient depletions associated with this medication. Talk to your doctor or pharmacist about whether taking a supplement is recommended or if you have any questions or concerns.

Mylan-Amilazide may deplete vitamin B1

How can this nutrient deficiency affect me?Vitamin B1, also known as thiamine, helps the body convert carbohydrates, fats, and proteins into energy. It also helps the body with normal growth, and is needed to keep your nervous system functioning properly, help produce cellular energy, and make chemical messengers that are involved in mood.

What can I do about this?Talk to your pharmacist about vitamin B1 deficiency. Vitamin B1 is available in supplement form. Before starting any nutrient supplement, always talk with your pharmacist first.

Mylan-Amilazide may deplete folic acid

How can this nutrient deficiency affect me? Folic acid is a nutrient that is vital to the production and development of new cells. It is important for the production, repair, and functioning of DNA for all cells. Folic acid deficiency is a serious concern during pregnancies since it increases the risk of birth defects. Anemia can also occur due to folic acid deficiency.

What can I do about this? Talk to your pharmacist about folic acid deficiency. Folic acid is available in supplement form. Before starting any nutrient supplement, always talk with your pharmacist first.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

January 31, 2019

Health Canada has issued new restrictions concerning the use of hydrochlorothiazide. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Allergy: Some people who are allergic to sulfa antibiotics or certain diabetes medications also experience allergic reactions to hydrochlorothiazide. Before you take amiloride – hydrochlorothiazide, inform your doctor about any previous adverse reactions you have had to medications, especially antibiotics. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Diabetes: Amiloride can affect kidney function, resulting in very high levels of potassium in the blood. Hydrochlorothiazide can cause a loss of blood sugar control. If you have diabetes, your doctor should closely monitor your condition while you are taking this medication, as it may affect blood sugar control. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Fluid and electrolyte balance: If you are taking amiloride – hydrochlorothiazide to treat symptoms of liver disease, it may cause the levels of electrolytes such as potassium, sodium, magnesium, chloride, and calcium in the blood to change while taking this medication. Symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, should be reported to your doctor as soon as possible. Your doctor will do blood tests regularly to monitor the levels of these electrolytes in your blood while you are taking this medication.

Gout and kidney stones: Hydrochlorothiazide may increase the level of uric acid in the body, resulting in symptoms of gout or kidney stone formation. If you develop painful, warm, and swollen joints or difficulty with urination, contact your doctor as soon as possible.

If you have a history of gout or kidney stones, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

High blood potassium: High blood potassium has been observed in some people who take amiloride either alone or with other diuretics (water pills). This happens mostly in seniors, in people with diabetes, and in people with liver or kidney disease. Warning signs or symptoms of high potassium include:

confusion

irregular heartbeat

nervousness

numbness or tingling in hands, feet, or lips

shortness of breath or difficulty breathing

unusual tiredness or weakness

weakness or heaviness of the legs

If you experience any of these symptoms, contact your doctor as soon as possible.

Systemic Lupus Erythematosus: People with Systemic Lupus Erythematosus (SLE or Lupus) may find that taking taking amiloride – hydrochlorothiazide causes the symptoms of SLE to flare up. If you have a history of SLE, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known whether amiloride passes into breast milk, but hydrochlorothiazide does. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children. This medication is not recommended for children.

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.